Christine Elliott hires special adviser to work with communities on Ontario public health merge

Theglobeandmail.com
Oct. 10, 2019
Jeff Gray

Ontario Health Minister Christine Elliott is hiring a special adviser to consult municipalities and local health officials before giving the green light to controversial plans to merge the province’s public-health units.

Jim Pine, the chief administrative officer of the County of Hastings in Eastern Ontario and a former provincial bureaucrat, is to travel across the province to hear the concerns being raised about the plans and come up with recommendations of his own to include in a confidential report to the minister.

His appointment, being announced on Thursday, marks the latest of a series of course changes for Premier Doug Ford, whose budget last April included a variety of targeted spending cuts that angered municipalities. Among them were sweeping changes for their public-health agencies, which track vaccinations, inspect restaurants and run supervised drug-consumption sites to combat the overdose epidemic.

The original plans were to amalgamate the province’s 35 local public-health units into 10 larger agencies by 2020-21, to save $200-million on back-office costs and duplication. It later emerged that the plans also included large funding cuts for municipalities, who were expected to pay millions more -- retroactively -- to keep local public-health programs afloat. Toronto was singled out for even larger cuts than other communities, and was initially told it would have to cover 50 per cent of its public-health budget.

“We’ve been listening. We heard from a lot of municipalities that they were concerned about retroactivity of some of the changes, and that the changes were coming too quickly,” Ms. Elliott said in an interview this week.

The furor over the cuts from mayors, including Toronto’s John Tory and his health board chairman Joe Cressy, prompted Mr. Ford to back off – only after weeks of pointing fingers at his critics. In August, he announced a new, less radical phased-in funding model for public health that would see municipalities cover 30 per cent of public-health costs. (Before the changes, the province paid 100 per cent for certain public-health programs, and 75 per cent for others.)

That new funding ratio will remain as is, Ms. Elliott said. But as Mr. Pine is set to begin his listening tour to hear from local officials, boards of health and workers’ unions across the province, the minister said her other plans are up for discussion.

While amalgamating the province’s 35 health units into 10 larger ones remains a goal, Ms. Elliott said the government may end up with a larger number of agencies and that no new boundaries have been set in stone.

The province has already been in talks with the City of Toronto, the Association of Municipalities of Ontario (AMO) and local public-health officials over the proposed changes.

But Ms. Elliott said Mr. Pine, who has held senior roles in Eastern Ontario municipalities for decades, can better understand the challenges some municipalities could face separating public health from their other operations.

Mr. Pine will also look for better ways to divvy up the responsibilities of public-health units, the minister said, reiterating her call for centralizing programs such as anti-smoking campaigns, rather than having them run locally in all 35 districts.

Mr. Pine has been given a year-long contract and will be paid up to $150,000, an amount that includes both his consulting fees and his travel expenses. His contract comes with a potential six-month extension.

“Public health has been a critical part of our communities in Ontario for a long, long time,” Mr. Pine said. “And so it is really important in the municipal sector, I believe, that we get it right.”

Mr. Pine will also consult paramedics and others on the government’s pledge to “streamline” land ambulance services, another cost-shared program to which Mr. Ford gave a funding boost in August after initially flat-lining the province’s contributions.

Jamie McGarvey, mayor of Parry Sound, Ont., and AMO president, praised the choice of Mr. Pine, a former AMO board member whom Mr. McGarvey described as “reasonable” and widely respected. But he said many municipalities still want to know why the public-health changes are needed.

“We need someone like Jim there, that understands the system, that understands municipal government,” Mr. McGarvey said.